Individual Membership Application

Application 
Renewal (please update each field, or enter N/C for no change)

Individual Member Annual Fees Including HST: $45.00
 

Name:
Permanent Address:
City:  :
Province:
Postal Code
Tel:
Tel 2:
E-mail:
Personal Web site:
Education:
Employer (Indicate Current or Previous):

Please briefly describe your career plans and interest in the environmental industry (apr. 150 words or less):

I hereby agree to join / renew as a member of NEIA. I acknowledge that this information I provided is accurate to the best of my knowledge, and I agree to the standards of NEIA and its Code of Ethics. I will forward payment to NEIA within 30 days.

Make cheque / money order payable to: NEIA, and send to:

NEIA
90 O'Leary Avenue
St. John's, NF  A1B 2C7